Compensatory exercise hyperventilation is restored in the morbidly obese after bariatric surgery

Obes Surg. 2008 May;18(5):549-59. doi: 10.1007/s11695-008-9437-7.


Background: Morbidly obese individuals may have poor compensatory hyperventilation during exercise. The objective was to examine pulmonary gas exchange and the compensatory hyperventilatory response during exercise pre- and post-weight reduction surgery in obese subjects.

Methods: Fifteen patients (age=39+/-8 years, body mass index=47+/-6 kg/m2), with an excess weight of 69+/-17 kg, were recruited. Pulmonary function at rest was assessed and arterial-blood gases were sampled at rest and all levels of exercise pre- and 10+/-3 weeks postsurgery.

Results: There was a loss of excess weight 21+/-6 kg (p<0.01). Waist and hip circumference decreased by 13+/-9 and 8+/-7 cm, respectively (p<0.01). Prior to surgery, there was no compensatory hyperventilation between rest and peak exercise as arterial PCO2 (PaCO2) remained unchanged (37+/-3 mm Hg). However, postsurgery, there was compensatory hyperventilation as PaCO2 decreased to 33+/-2 mm Hg at peak exercise (p<0.01), with no change in peak oxygen consumption (VO2peak in L/min). Multiple linear regression revealed that the restored ventilatory response to exercise was most strongly associated with the reduction in overall fat mass (adjusted r2=0.25; p=0.03). Total weight loss of 21 kg induces adequate compensatory hyperventilation that begins to show at about 50% of VO2peak, resulting in improved gas exchange at moderate to peak exercise intensities.

Conclusion: Improvement in compensatory hyperventilation is most closely related to loss in overall fat mass.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Composition
  • Comorbidity
  • Exercise / physiology*
  • Humans
  • Hyperventilation
  • Middle Aged
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / physiopathology*
  • Obesity, Morbid / surgery
  • Oxygen Consumption
  • Oxyhemoglobins / metabolism
  • Postoperative Period
  • Pulmonary Gas Exchange
  • Sleep Apnea, Obstructive / epidemiology
  • Spirometry


  • Oxyhemoglobins